Will The FDA Ever Get Over Its Hemo-phobia?

The FDA is reconsidering its lifetime ban on blood donations by gay men. But, under the proposed reform, gay men would be able to donate only if they had gone one year without having any gay sex. “I hope none of us will qualify,” Tim Murphy snarks. Why he opposes the new rule:

The current test used to screen all donated blood for HIV can detect the actual virus as soon as 9 to 12 days after infection. (That’s compared to the first-generation test, which could only detect antibodies to the virus, and not until several weeks after infection.) Given that narrow window of “blind spot” risk on the newest test, the question all donors should be asked on the form they fill out should be something like: “In the past” — let’s make it six weeks — “have you engaged in HIV risk behaviors — including condomless anal or vaginal sex, or shared drug-injecting paraphernalia — with an HIV-positive person or someone whose HIV status you did not know?” (The same question should be asked about hepatitis B or C, which donated blood is also screened for, as well as all other known blood-borne pathogens.)

Jason Millman reviews the extensive evidence against the current policy, noting that other countries have found ways to screen out HIV-positive donors without excluding an entire segment of the population:

The scientific and medical communities have increasingly rejected the ban currently in place in the United States. The American Medical Association, the nation’s largest physician organization, voted last year to oppose the ban, calling it discriminatory and not based on sound science. Instead, the AMA urged federal policymakers to take a more personal approach assessing each individual’s level of risk. The approach recommended by an HHS advisory committee last month falls short of that standard. And it still falls short of what a number of other countries have done to allow blood donations from gay and bisexual men.

Countries, such as Italy and Spain, use an individual risk assessment for all would-be donors, regardless of sexual orientation. Italy’s blood donation policy, which has been in place since 2001, screens everyone for risk factors, like whether they’ve participated in prostitution, injected drugs or had multiple sex partners with unknown sexual behavior. The policy hasn’t resulted in a significant increase in HIV-positive gay and bisexual male blood donors, according to a study released last year.

And Mona Chalabi estimates how many more eligible blood donors we’d have if the ban were dropped entirely:

[B]ased on the CDC’s numbers on sexual orientation (and setting aside any other possible restrictions on those individuals giving blood), one could estimate that about 2.6 million U.S. men are currently prohibited from giving blood. But that’s a misleading calculation. The sexual orientation that a person states in a survey is not a perfect indicator of his sexual behavior. … Although less than 3 percent of U.S. men say they are gay or bisexual, in a separate survey almost 9 percent said they have had a male sexual partner. Researchers at the Williams Institute, a think tank on sexual orientation and gender identity, used data from the 2008, 2010 and 2012 General Social Survey (GSS) to estimate that 8.5 percent of men say they have had at least one male sexual partner since age 18.

Based on that figure, there would be about 4.2 million more eligible blood donors in the U.S if the FDA were to lift the ban entirely.